In Our Care: "Polio"
Ray Stewart of WOI-TV Ames, Iowa along with Iowa State University, produced "In Our Care," a 13 week series of documentaries filmed inside Iowa's state institutions. The series won the 1952 National Sylvania Television Award for Production Excellence.
Ray Stewart: Hello, my name is Ray Stewart. I'm speaking to you from the studios of WOI TV in Ames, Iowa. I would like to tell you a story, a story of Mertilla Phones, a 10-year-old girl who lives in Des Moines, Iowa. When you think of a 10-year-old, what do you think of? Well, when I think of one, I think of a happy child, a girl who even if she has been sick is recovering and again will be among her sturdy, healthy little friends. I think of the things that make little girls shake with laughter and clap their hands with glee. But when I think again of Mertilla, I think of polio. I remember that many children do not jump up and down and shake with laughter or clap their hands with glee.
Ray Stewart: This is Mertilla's mother, Mrs. W.H. Phones of Des Moines, and I believe that the best way to get a story about an illness of a little girl is to ask the little girl's mother. So, Mrs. Phones, I would like to ask you first of all, how did you know that Mertilla had polio?
Mrs. Phones: Well, actually, she was ill for about six days before it was diagnosed. Note polio has symptoms that are so very much like so many others. Her first symptoms, for instance, were an intense weariness and a dry throat, no fever even. But I put her to bed. A day later, she still had the sore throat and she had a fever of 101°. Well, I kept her down for a couple of days and after two days, her fever abated and I let her get up for a little while on Friday afternoon, the third day of her illness. That evening, she had a very severe earache, and I was quite concerned, so I had the doctor look at it, and he found that she had a red ear and no fever. He gave her some Benadryl and some nose drops. And that night, she had a very severe vomiting attack, which frightened me nearly to death because she just choked so when she did it. So I had him check her again the next day. And I...
Ray Stewart: Well excuse me. These symptoms that you're talking about sound like they could be symptoms for most anything.
Mrs. Phones: They could be. They could actually be for something like measles or any of the numerous childhood diseases. Might even be a mild attack of flu. But on Sunday, when the doctor examined her, he noticed one thing that made him suspicious. She had a sort of double vision. And he couldn't find any stiffness, but he said if she were no better the next morning, she should go to the hospital and have a lumbar puncture. So that night, she had an even worse vomiting attack than she had before and I was really quite frightened and made arrangements immediately the next morning to take her down.
Ray Stewart: This lumbar puncture, what is that, taking fluid out of the spinal column?
Mrs. Phones: Well, as near as I can tell, it is a withdrawal of some spinal fluid and in the analysis of it they discover the virus of the polio. So that is one sure way that you can tell that the polio is there.
Ray Stewart: She then was diagnosed as having polio, is that right?
Mrs. Phones: That's right. She was diagnosed as having polio, which was frightening enough in itself. But after the doctor listened to her rather peculiar harelip speech, he said that it was bulbar polio.
Ray Stewart: Now before we go any farther in this thing, what, what other types could she have had?
Mrs. Phones: Well, there are several types of polio. There is the spinal type in which the virus lodges in the spinal column and it causes, as I understand it, a paralysis of the limbs and sometimes the body. Then there is the spinal bulbar, which is a combination of the spinal and bulbar polio. Bulbar polio is where the virus lodges in the nerve centers of the brain, usually starts in the breathing and swallowing centers and then moves out from there unless its progress arrests.
Ray Stewart: Bulbar, I believe, is supposed to be about the worst kind isn't it?
Mrs. Phones: Well, it, if a person recovers from bulbar polio, they recover almost completely. The danger of bulbar polio is that if the virus moves into, for instance, the circulatory center of the brain, it just means that the heart stops and the child dies.
Ray Stewart: There are more deaths then, probably, from bulbar polio than the other types.
Mrs. Phones: That, that is the reason why there are more.
Ray Stewart: Um, huh. Now, after you got into there and they had diagnosed that, did they put her in an iron lung or respirator?
Mrs. Phones: No, not at that time. They made provision for this by having me sign a release for a tracheotomy in case that was necessary.
Ray Stewart: This is an operation that—what does it have to do with the iron lung?
Mrs. Phones: Well, you see, in the bulbar, in case of the bulbar polio, the air passages fill up with a mucus, which must be suctioned off. And you cannot put a person with this mucus in their throat in an iron lung and have it drawn in and out. You have to make a bypass for the air to go in and out.
Ray Stewart: So they can't swallow or clear their throat or anything and so the mucus might strangle them.
Mrs. Phones: That's right. You use a suction machine a great deal in bulbar in order to pull the mucus out of the nasal and throat passages. But if it gets down far enough where you can't reach it, then it's often necessary to do a tracheotomy so that the mucus can be removed by going through the tracheotomy incision.
Ray Stewart: Now, I think it would be well here to explain what this tracheotomy is. As we have explained, of course, the person is unable to swallow and has some difficulty in that manner, and so it is necessary to give them some mechanical aid to clearing the mucus out of their throat and so forth. A tracheotomy is a very delicate operation to perform and though the operation itself is a very short one, it requires a great deal of time for preparation. Now in this particular case, Mertilla was placed in an iron lung. This is not usual, but Mertilla was placed in an iron lung, which was wheeled into a small room and the lung was not turned on. A large tray of instruments was placed in the doorway and a suction machine and oxygen equipment were ready for use if needed. In this operation, the doctor cut into the windpipe and inserted a tube into it. Then the mucus which collects in the windpipe and the bronchial tubes and the lungs was suctioned out and the air passages could be kept clear. Since Mertilla's lungs were paralyzed, she herself could do nothing about clearing up this mucus, as we have explained, and so it all had to be done for her and done instantly so that she could be able to breathe. A tracheotomy also allows oxygen mixtures to be fed directly into the windpipe. The tube which is inserted is a silver one which is curved to fit the windpipe and has an inner tube which can be removed for cleaning and for suctioning. There is a hollow T attached to this tube through which mixtures of oxygen can be fed so that as much air is not necessary as might be otherwise so they can keep the patient alive on almost, well, on large amounts of oxygen. Although only a few minutes have passed until the operation is over and the lung was turned on, Mertilla's waiting mother thought it was like an eternity. This was her daughter who lay encased in an iron lung with a silver tube in her throat.
Ray Stewart: Now here was a daughter who was being kept alive by the mechanical means of our modern society. Speaking of mechanical means, I would like to continue here for a moment and bring in something that was not available to Mertilla at the time she was in the hospital, that is, a rocking bed. Now a rocking bed is something that helps the patient to be out of the lung and aids them in breathing. I believe at this time it was only about a year old. I made a sound on film interview of one of the patients on a rocking bed and I believe that's the best way to give you an idea of what it is.
Ray Stewart: I would like for you now to meet Mr. Harris Lee Cornish here, who is from Sully. Harris, how old are you?
Ray Stewart: You want to tell me what this contraption is you're on here?
Harris: It's a rocking bed.
Ray Stewart: A rocking bed. How, how does it work? What does it do for your?
Harris: It helps me breathe.
Ray Stewart: Um huh. What do you do? Do you come out on this rocking bed after you're out of the lung, do you?
Ray Stewart: It helps you get out of the lung. How long are you out now?
Harris: About seven hours on average.
Ray Stewart: How long have you been here, Harris?
Harris: Eleven weeks.
Ray Stewart: That's almost three months, isn't it? Are you getting along pretty good do you think?
Ray Stewart: And over here is Mrs. Cornish, who is Harris's mother. Do you live on a farm out there near Sully?
Mrs. Cornish: Yes, we do.
Ray Stewart: Where is Sully exactly?
Mrs. Cornish: It's about 50 miles east of here.
Ray Stewart: Now, someone was telling me very a interesting thing about your farm, about how the neighbors were helping you when you had to bring Harris here.
Mrs. Cornish: Yes, they picked our corn for us, which we think was very nice.
Ray Stewart: What do you think about this rocking bed?
Mrs. Cornish: Well, I just think a lot of it. It has kept him off the respirator longer where otherwise he would have to be in.
Ray Stewart: He already has to be either on the rocking bed or in the respirator, does he, or can he get off his rocking bed sometimes?
Mrs. Cornish: Well, he gets off the rocking bed and then he has his treatment and usually on Friday afternoons they have music upstairs, and he goes up there on a stretcher which is about an hour.
Ray Stewart: So you can get off of this too for about an hour. Are you able to sit up very much?
Harris: Not too much.
Ray Stewart: Um huh. How about your school work and everything—are you able to keep up here.
Harris: Well, I started a couple of days ago.
Ray Stewart: Oh, you're back in school then. What grade are you in?
Ray Stewart: Seventh grade. Is this a consolidated school that you go to?
Harris: It's just a country school.
Ray Stewart: A little country one-room school where you study. How many brothers and sisters do you have?
Harris: Well, I have two brothers and no sisters.
Ray Stewart: Two brothers, three people in your family then? Do you remember very much about when you were first coming in here?
Harris: Not very much.
Ray Stewart: What were the circumstances in which he came here? I mean, how did you find out that he had polio and so forth?
Mrs. Cornish: Well, he got up with a severe headache on Sunday morning and he had a stiff neck and his back was sore. And we called our doctor in to see him, Dr. Harrison, and he had him taken up to the hospital there and he kept him and he diagnosed it as polio right away.
Ray Stewart: Well, and then you moved him here.
Mrs. Cornish: Yes, on Monday morning, he stayed in the hospital there on Sunday night and then Monday morning they brought him here in the ambulance.
Ray Stewart: Well, how soon did you have to put him on a respirator?
Mrs. Cornish: Monday, or he had oxygen during the night Monday and I think for three days he was in oxygen and then he eventually got worse and then they had to put him in the respirator.
Ray Stewart: So it became necessary that fast?
Mrs. Cornish: Yes.
Ray Stewart: If there hadn't been a respirator on hand, you might have lost him?
Mrs. Cornish: That's right.
Ray Stewart: That would be very difficult for everybody concerned. There is one thing about this bed that interests me very much. And I noticed it all over the hospital and that is this footboard down here. What is the purpose of that?
Mrs. Cornish: That is to keep the bottom of their feet straight so when they get up on their feet again that they don't have the trouble of having their feet droop.
Ray Stewart: Well I see they he has no control over his muscles there... No. so his feet would just droop over.
Mrs. Cornish: That's right, If it wasn't for that.
Ray Stewart: (Well you can see with that bed) He's well on his way to being cured of polio and now comes the therapies and things of restoring those muscles and so forth. The rocking bed has some therapeutic value, and then there's another thing that is used which is known as hot packs. So I'll throw this question back over to Mrs. Phones here to tell me a little bit about the hot packs. I believe Mertilla used them, did she not?
Mrs. Phones: Yes, only after she was taken out of the lung. I think we'll learn more later about the value of hot packs in the earlier stages of the disease, but hers were used primarily to relieve stiffness and to get her so that she would be more pliable again.
Ray Stewart: This is something that I suppose we should give you a little bit of explanation of. It's used for both stiff muscles and some muscles that can be restored but have been inactive because of the disease. The same principle holds true in the treatment of polio. The application of moist heat to the muscles helps to keep them in good condition until some power returns. Cloths are boiled in intensely high heat and then are spun dry so they retain their heat but won't burn the children. They are applied wherever muscles are stiff or useless. Hot baths do the same job of relaxing the muscles. This boy is one of the hot baths. But to her, as to Mertilla, no matter how well they may be progressing, it's still a hospital bed and it's still not home and they're still very sick children.
Mrs. Phones: That's why it's a wonderful feeling when, if you're one of the lucky ones, the day comes that the doctor says your child can go home. However, you must continue therapy treatments at home so I had to go to school again. I had to go to a physical, registered physical therapist and learn how to help Mertilla regain the strength and utility of her muscles.
Mrs. Phones: Do you need a hand?
Physical therapist: (Unknown) The hamstring is really tight. Do you need a hand? Let me start on the back. Lean forward. And you've got to put your chin to your chest. Could you hold them there? Now come. (Unknown) That's very good. You still can't get all the way down.(Unknown) You have to lift her up, lift her up high at home. That's how we do it.
Mrs. Phones: All right.
Ray Stewart: There are so many things involved in the treatment of a polio patient when he's on his way to recovery. There are so many developments in this field and things that a layman cannot answer, that I have asked Dr. Lee Hill of Des Moines to come to the studio to answer some questions for you about polio. Dr. Hill, I don't know exactly where to start on asking questions about polio. Do we know very much about it actually, I mean, are you able to treat it, the polio itself I mean.
Dr. Hill: No, there is no specific drug for the treatment of polio such as there is, for instance, for meningitis or pneumonia. There are some hopeful signs in... Gamma globulin would you like me to talk about it?
Ray Stewart: I've heard the use words like gamma globulin and that sort of thing.
Dr. Hill: Yes, gamma globulin certainly has some promise of being good. However, I think a warning should be issued that it's not going to stop polio by any means.
Ray Stewart: Just what is this gamma globulin?
Dr. Hill: Gamma globulin is a portion of blood serum and it's obtained from blood that is taken from, for instance, the people who give, donate their blood for Korean soldiers. And some of that blood that may have run out is then used to process and the serum part of it is saved and the protein broken down and gamma globulin is separated out. Now gamma globulin is very useful in preventing measles. It does a grand job in modifying measles. In fact, we've used it for that purpose for a long time. But now it was seen at Sioux City and Houston and Provo last year in their experimental studies that gamma globulin also has a protective effect in polio. It will last only about a month so that you can see in a whole season of polio that is going to be very difficult to decide whether to give it once in a season or to give it three or four times. It's going to be impossible, it seems to me, to get enough to give to every child in the United States; you just couldn't do it.
Mrs. Phones: As I understand it, Dr. Hill, there are only going to be about 1,250,000 cc available for the season next year and that because of the shortage for the entire population that it will have to be issued by the National Research Council as they see fit.
Dr. Hill: Well, I think it will have to be controlled in some way. I'd dislike very much to be the person who had to decide whether this child or that child received the gamma globulin. But I'm sure it should tried out and then more learned about it, but I think they, and I want to repeat, that I don't think people should feel that an answer has been found to the polio problem in gamma globulin.
Ray Stewart: Gamma globulin, then, is not something that if you have a polio epidemic in Des Moines or in Omaha that they can fly in this thing and vaccinate all of the children there against it, is it.
Dr. Hill: Well, we could if that is the only area involved, perhaps, but supposing a number of areas were involved, you're going to run out of gamma globulin. The difficulty is going to be to get enough of it. Somebody's got to decide which ones of those children who are exposed are going to get it, and that's going to be difficult. Now they are developing means, of course, of increasing the supply of gamma globulin. I think one method now is a machine that will, when the donor is giving his blood, will take out the red cells, or take out the serum, rather, and save the red cells and then put the red cells back in. So he can give his blood more frequently, perhaps.
Mrs. Phones: Of course, though, the prime thing is we want to stop it. We don't want to just alleviate it.
Dr. Hill: That's right but for all purposes; the real solution to polio is going to be a vaccine. And I personally feel, from what I know that we're not too far away from the development of a vaccine that will be effective against polio. The fact now that the polio virus can be grown in the laboratory on tissue culture has meant a tremendous advancement in research. Before, we had to use monkeys and that was time consuming and expensive, but now I think that we're pretty close to an effective vaccine. The difficulty is that there are three strains of polio virus, as you know, and we have to have a vaccine for all of them if it's going to be effective. That will, of course, be the answer to polio, as it has been to diphtheria and to smallpox and to many of the other diseases that at one time were probably just as dreadfully looked upon as we look upon polio today.
Ray Stewart: I think of all of these vaccines and this gamma globulin and these things, and I see an awful lot of money involved. I talked with these patients in the hospital and I saw people whose bills were approaching $5000 for treatment, and then I think of the March of Dimes and that thing, and I wonder if Mrs. Phones might not be able to help me on that. You've been directly involved there.
Mrs. Phones: Well, I have been directly involved. It's the National Foundation itself is a wonderful organization because it is a morale builder. Even if you don't need any help from them, you know that the equipment will be there when it's needed. The iron lung, Mertilla's iron lung was flown in from North Carolina, Dr. Hill, just two days before she went into it. And the National Foundation, the chapters here in the state have spent over $12,000 this year bringing and transporting equipment in and around the state, and that's a lot of money just for trucking, to say nothing of how much it costs. For instance, an iron lung costs $1800, over $1800, that's 18,000 dimes, and that's why we want people to realize that this is a march of dimes and dollars, not just the March of Dimes. The rocking bed costs 16,000 dimes, and that's a lot of money too. So I just feel that the National Foundation is doing a wonderful thing, not only in supplying equipment and recruiting personnel, therapists and nurses, and training of these therapists, but I feel that they are doing a wonderful thing in building the morale of the sick child's parents. And not only that, they are the ones who are sponsoring the grants, a large number of them, for the research facilities for discovering this vaccine.
Ray Stewart: It seems to me that it would be quite helpful, and maybe I can ask you about this. If you were faced with these great financial troubles, I'm speaking of a person now, isn't it a great help to you to have the polio foundation say, "Don't worry about it"?
Mrs. Phones: That's right. Even if you don't need it, you don't know. You might need it, your child goes into the hospital. If they develop a serious case of spinal paralysis where they have a long serious treatment and are seriously involved. Their muscles need a great deal of therapy and they are hospitalized and maybe they have to have an iron lung and oxygen for a long time, then it's a wonderful thing to know that there's an organization that stands behind you, willing to help in all the ways they can.
Ray Stewart: There are so many things that figure into the treatment of polio. We've talked with Dr. Hill and we have talked with Mrs. Phones and we've looked into this thing. We can't possibly tell you everything about it. I'd like to leave you with this note that five weeks after Mertilla entered the hospital, she walked out of it. A little girl who had had the dread disease of polio and had conquered it. And so Mertilla's story ended happily and she was one of the lucky ones. But before we part, I'd like you to meet a boy who was in the hospital with Mertilla. But who didn't walk out. With us in the studio is 18-year-old Jimmy Williams of Ames, Iowa. Now, Mertilla's story actually happened about three years ago and Jimmy was there and he has been, as you will see him, since that time. We'd like to talk a little bit with Jimmy now.
Ray Stewart: Hello, Jimmy. How are you?
Jimmy: I'm good.
Ray Stewart: I'd like to ask you a few questions, but first of all did you live in Ames when you first went to the hospital?
Jimmy: No, I didn't. I lived in Rockwell City.
Ray Stewart: Oh, I see. Do you remember, were you very sick when you went in?
Jimmy: No, I wasn't. I wasn't very sick for three or four days...
Ray Stewart: Well I see.
Jimmy: after I came here.
Ray Stewart: Uh huh. And then you got sick in a hurry. You were in the lung, I believe.
Jimmy: That's right.
Ray Stewart: Were you, how long were you in the lung, do you remember?
Jimmy: Just about four months.
Ray Stewart: Um huh. And then you, you've been out ever since?
Jimmy: That's right.
Ray Stewart: Uh huh. And you moved from Rockwell City to Ames and you live out there. I think I saw some, your picture in the paper not long ago.
Jimmy: That's right.
Ray Stewart: Where they fixed you up with a mirror and that sort of thing so you can watch the boys playing out in the yard.
Jimmy: That's right, so I can see out in the backyard there.
Ray Stewart: How do you spend your time? I want to ask you about this thing here too. I guess it all goes together.
Jimmy: That's right. This first switch here can operate my radio. The next one I can turn on the lamp, on and off. This one isn't connected up, but this one here I can ring for my nurse.
Ray Stewart: You have a full-time nurse, then?
Jimmy: That's right.
Ray Stewart: You can move your three fingers here, can you?
Jimmy: That's right, not very much, though.
Ray Stewart: You... you listen to the radio. What else?
Jimmy: I watch television quite a bit.
Ray Stewart: Um huh. I suppose you watch just above everything we have on the air.
Jimmy: Just about, starting in the morning.
Ray Stewart: What is, do you have a favorite radio programs in the morning.
Jimmy: That's right, music mostly.
Ray Stewart: Uh huh. You really have a nice thing there, then to help you out...
Jimmy: That's right.
Ray Stewart: with your nurse and things. Why, it looks like they've got you fixed up pretty good with your mirror and your window and so forth. Well, thank you very much, Jimmy. The story of Mertilla and the story of Jimmy is made more haunting and more real because it has happened and is happening to many of us. Each year, there is more polio in America, and each year, more children experience the same things that Mertilla and Jimmy experienced. Each year, it happens to someone else's child, and next year, it could happen to yours. If ever a nation is faced with a grave and almost soul-shaking responsibility, we face it now. And our responsibility is to our children who are in our care.
(Voiceover) The doorbell may be ringing now. Answer it. A mother is waiting to talk to you. Talk to her. Talk to the thousands of mothers who are taking part in the Mothers' March all over the country and to give, give every penny and every dime you can afford. Give to fight infantile paralysis and give our children a chance.
(Voiceover) This special presentation of In Our Care was produced by WOI TV Ames, Iowa as a public service program in the interests of the fight against infantile paralysis. The producer was Ray Stewart. Director was LaMar Smith. The script was written by Marjorie Abrams. Technical director was Dawn Harr. Cinematography was by John Raddatz. The part of Mertilla was played by Jean Hensing of Ames, Iowa.